By Dr. Asghar H. Asghar
Abstract:
Adaptive radiotherapy (ART) is transforming radiation
oncology by enabling real-time adjustments to treatment plans
in response to anatomical and biological changes during the
course of therapy. Driven by advances in imaging, deformable image registration, and artificial intelligence, ART enhances
precision, reduces toxicity, and supports personalized
treatment. A key component of this evolution is the integration
of advanced delivery techniques such as Intensity-Modulated
Radiotherapy (IMRT) and Volumetric Modulated Arc Therapy
(VMAT). While both offer highly conformal dose distributions,
VMAT provides faster delivery with superior dose conformity
and reduced treatment time compared to traditional IMRT,
making it particularly well-suited for adaptive workflows.
VMAT’s continuous arc delivery facilitates efficient plan
adaptation in response to daily anatomical variations, whereas
IMRT’s fixed-field approach, although effective, is more
time-intensive and less flexible. Emerging technologies such as
MR-guided ART and AI-driven auto-contouring are further
optimizing both VMAT and IMRT applications. As ART
continues to advance, comparative evaluation of these
modalities within adaptive protocols will be essential to guide
clinical decision-making and maximize therapeutic outcomes.